Arthritis occurs as a result of inflammation in the joints of the body. It can be caused by obesity, old age, fractures in the bones, or bacterial and viral infections. Arthritis can limit one’s ability to perform everyday activities due to the swelling and pain of the joints.
In order to qualify for disability benefits, your arthritis condition must be so severe that it prevents you from working, and it is expected to last for at least a year. Having severe arthritis can qualify you for benefits depending on how much the condition inhibits your ability to participate in any substantial gainful activity.
How the SSA Determines Benefits for Arthritis
The SSA follows a 5-step procedure to determine if you qualify for benefits due to your arthritis condition. These 5 steps are as follows:
1. Determining if you can Work
When the SSA receives your application, they first determine whether you're currently working, and how much you’re earning from your work. If you are earning at least $1,170/month or more as of 2017, you can’t qualify for benefits because the SSA will determine that you’re able to perform substantial gainful activity.
2. Residual Functional Capacity (RFC) Analysis
The SSA also looks at how your arthritis is preventing you from carrying out daily activities that would be required in a work environment. Actions such as your ability to stand and walk for long periods, lift heavy objects, and bending or kneeling are assessed by the SSA from the medical records that you submit.
3. Determining if your Arthritis Meets Medical Criteria
There are 4 medical listings kept by the SSA that are related to arthritis (explained in the next section). If you meet any of these listings, you can automatically qualify for disability benefits for arthritis.
4. Analyzing Past Work
In certain cases, the observable symptoms of your arthritis may not be enough to medically qualify you for benefits. If your outside symptoms do not tell the whole story, the SSA will look into your past work to determine if you are able to carry out those functions that you used to in the past. If your arthritis condition has resulted in a significant change in your ability to do previous work, you may qualify for disability benefits.
5. Ability to do Other Work
The SSA will determine if you’re capable of doing any other type of work based on your age, previous work experience, educational level, and mental/physical health. If the SSA determines that you can be capable of doing other substantial gainful activity through the proper training or treatment, they will typically not grant you benefits. However, in cases where your condition, age, or skill set prevents you from doing any other work, the SSA will approve your application.
Types of Arthritis and Disability: What can Automatically Qualify you for Benefits?
The SSA keeps a listing of medical conditions/impairments that are associated with arthritis. Under these listings, there are several arthritis conditions that meet the medical threshold of the SSA and immediately qualify you for benefits. These include:
Arthritis can cause your joints to experience major dysfunction due to deformities such as misalignments, shortening of the joint or chronic pain and stiffness. If your condition has led to a dysfunction in any of your joints, you can automatically qualify for benefits. Your medical records should prove that your joint isn’t functioning normally through x-rays and other medical imaging tools.
Your arthritis should also show a defect in your hip, ankle or knees that makes it difficult to walk; or a disruption in your shoulder, wrist or elbow that makes it difficult to hold and lift items.
You Underwent Surgery on a Weight-Bearing Joint
If arthritis caused you to undergo surgery on a major joint that supports your weight (such as your hips or knees), and the procedure will make you unable to walk effectively on your own for a period of at least one year, you can automatically qualify for benefits under this SSA listing.
Arthritis of the Spine
You may automatically qualify for benefits if your arthritis is affecting your spine and compromising any nerve roots within the spinal cord. Arthritis should cause your spinal cord to experience widespread pain, limited flexibility, and inflammation that necessitates a change in positioning every few hours. Narrowing of the spinal canal that leads to lower back pain can also qualify you for benefits.
The 4th arthritis condition that can automatically qualify you for benefits under the SSA listings is when arthritis causes inflammation or deformities in your knees, ankles, shoulders or elbows. When such deformities in the joints prevent you from working, you can meet the SSA listing for arthritis and receive benefits.